Treatment adherence and quality of life in colombian patients with lupus nephritis.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY Lupus Pub Date : 2024-10-01 DOI:10.1177/09612033241280548
Alex Domínguez-Vargas, Henry González-Torres, Álvaro Martínez-Bayona, María Sanguino-Jaramillo, María Vélez-Verbel, Andrés Cadena-Bonfanti, Carlos Guido Musso, Santos Depine, Eduardo Egea, Gustavo Aroca-Martínez
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Abstract

Background: As with many other chronic diseases, systemic lupus erythematosus (SLE) and lupus nephritis (LN) have significant impacts on the health-related quality of life (HRQoL). Medication non-adherence is a significant challenge in the management of SLE, with consistently up to 75% of patients being non-adherent with their SLE medications. There is a need to assess the patient's perspective using patient-reported outcomes (PROs) to better understand the current impact of LN on HRQoL and treatment adherence in our region. The aim of this study was to explore the relationship between HRQoL and treatment adherence in patients with LN from the Colombian Caribbean.

Methods: A cross-sectional study was conducted from June to December 2022, including patients with biopsy-proven LN. HRQoL and treatment adherence were assessed using the Lupus Quality of Life (LupusQoL) and the Compliance Questionnaire in Rheumatology 19 (CQR19) instruments, respectively. Patients were categorized as adherent or non-adherent based on medication intake (defined as >80% correct dosage). Principal component analysis (PCA) was employed to identify principal components between adherent and non-adherent patients.

Results: A total of 42 patients with LN were included. Of these, 38 (90%) were female, and the mean age was 31 ± 10 years. Proliferative class IV was the predominant histopathological profile (90%). Twenty-five (60%) patients were categorized as non-adherent. Across all LupusQoL domains, a comprehensive range of responses was observed. Pain, planning, and intimate relationships domains remained unaffected, while burden to others domain had the lowest score. Poorer planning score correlated with older age (r = -0.72; p < .05) and longer disease duration (r = -0.74; p < .05). SLEDAI-2 K correlated with the pain domain (r = -0.78; p < .05). Non-adherent patients exhibited significantly worse pain domain scores compared to adherent counterparts (p < .05). PCA showed strong interactions between planning and pain, as well as between physical health and body image domains.

Conclusions: LupusQoL pain domain scores were significantly worse in non-adherent patients compared to adherent patients. Effective pain management could be a determinant in HRQoL and treatment adherence rates in our population.

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哥伦比亚狼疮性肾炎患者的治疗依从性和生活质量。
背景:与许多其他慢性疾病一样,系统性红斑狼疮(SLE)和狼疮性肾炎(LN)对健康相关的生活质量(HRQoL)有着重大影响。不遵医嘱用药是系统性红斑狼疮治疗过程中的一个重大挑战,高达 75% 的系统性红斑狼疮患者不遵医嘱用药。有必要使用患者报告结果(PROs)来评估患者的观点,以便更好地了解本地区 LN 目前对 HRQoL 和治疗依从性的影响。本研究旨在探讨哥伦比亚加勒比海地区 LN 患者的 HRQoL 与治疗依从性之间的关系:一项横断面研究于 2022 年 6 月至 12 月进行,研究对象包括经活检证实的 LN 患者。分别使用狼疮生活质量(LupusQoL)和风湿病学依从性问卷19(CQR19)工具对患者的HRQoL和治疗依从性进行评估。根据药物摄入量(正确剂量>80%)将患者分为依从和非依从两类。采用主成分分析(PCA)来确定依从性患者和非依从性患者之间的主成分:共纳入 42 名 LN 患者。结果:共纳入 42 名 LN 患者,其中 38 人(90%)为女性,平均年龄为 31 ± 10 岁。组织病理学特征以增生性 IV 级为主(90%)。25名患者(60%)被归类为非依从性患者。在狼疮生活质量的所有领域中,观察到了一系列全面的反应。疼痛、规划和亲密关系领域未受影响,而对他人的负担领域得分最低。较差的规划得分与年龄较大(r = -0.72;p < .05)和病程较长(r = -0.74;p < .05)相关。SLEDAI-2 K 与疼痛领域相关(r = -0.78;p < .05)。与坚持治疗的患者相比,未坚持治疗的患者在疼痛领域的得分明显降低(p < .05)。PCA显示,计划与疼痛之间以及身体健康与身体形象领域之间存在很强的交互作用:结论:与坚持治疗的患者相比,未坚持治疗的患者狼疮QoL疼痛领域得分明显较低。有效的疼痛管理可能是影响我们人群的 HRQoL 和治疗依从率的一个决定因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
期刊最新文献
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